Clinical Problem PICOT Statement
Clinical Problem PICOT Statement Essay
Clinical Problem PICOT Statement Essay

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Hello I need the same writer assigned to this order as my first order #219868. This assignment piggybacks off the same topic / PICOT statement. 2-4 sources used on the last paper should be integrated into this one.

PICOT Question-Among adult patients in the ICU with a central line (Population) does the use

of chlorhexidine wipes (Intervention) compared to traditional soap and water basin baths

(Comparison) reduce the rates of CLABSIs (Outcome)within 10 weeks(Time)? Clinical Problem PICOT Statement Essay

Assignment details: Review the Topic Materials and the work completed in NRS-433V to formulate a PICOT statement for your capstone project.

A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the timeframe needed to implement the change process.

Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement:

Evidence-Based Solution

Nursing Intervention

Patient Care

Health Care Agency

Nursing Practice

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Clinical Problem PICOT Statement Essay

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion

Clinical Problem

This paper addresses the issue of increased rates of CLABSIs among adults with a central line admitted in ICU settings. This problem has led to most of these patients staying for more than 10 weeks in the ICU with generally poor health outcomes. According to Marschall et al. (2014), the most commonly reported HAIs with significant morbidity and mortality among inpatients are CLABSIs whose occurrence is triggered by the use of short-term devices. These devices permit microorganisms on the skin to invade inner tissues resulting in complications and poor health outcomes. According to a report by the Centers for Disease Control (CDC), it is estimated that up to 25% of deaths associated with HAIs comprise CLABSIs (Frost et al., 2016). Those at high risk are critically ill patients who are hospitalized in ICU settings since they use invasive devices, are mechanically ventilated, have numerous comorbidities, undergo invasive procedures and are immuno-deficient. Clinical Problem PICOT Statement Essay

The APIC (Association for Professionals in Infections Control and Epidemiology) associates CLABSIs with longer hospital stays, increased medical costs, increased mortality and morbidity and generally poor health outcomes (Marschall et al., 2014). Various evidence-based strategies that aim at preventing CLABSIs such as screening and isolating contacts colonized with multi-drug resistant organisms, using protocols for hand hygiene, vascular access devices insertion bundles, and aseptic techniques have been implemented in ICU settings (Marschall et al., 2014). However, some of these strategies have not only proven to be less effective but also very difficult to maintain. Without proper intervention, it is expected that CLABSIs incidences, mortalities, morbidities, and other negative health outcomes will continue to increase. Experimental studies support the use of chlorhexidine gluconate wipes to reduce colonization of the skin by bacteria and the incidences of CLABSIs. For instance, Boonyasiri et al., (2016) reveal that cleaning a patient’s skin with chlorhexidine gluconate reduces colonization and risk of CLABSIs from 23% to 50%.

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Evidence-Based Solution
Currently, existing research indicates that the use of chlorhexidine gluconate wipes is an effective evidence-based strategy for preventing CLABSIs. Chlorhexidine is a topical antiseptic that is used to decolonize the skin and prevent cross-infection (Boonyasiri et al., 2016). As a long-term antibacterial agent, it reduces the colonization of a patient’s skin with micro-organisms and prevents secondary contamination of a patient’s environment. Its broad-spectrum properties promote its use when conducting invasive surgical procedures and inserting intravenous catheters (Marschall et al., 2014). This is also attributed to the fact that it is highly efficacious and safe against a wide range of fungi, gram-positive and negative bacteria and viruses. Clinical Problem PICOT Statement Essay

Nursing Intervention
To effectively address the issue of high incidences of CLABSIs in ICU settings, the most recommended interventions are those which target prevention efforts. This is attributed to the fact that research links CLABSIs to poor health outcomes where patients either develop complications, die or are admitted for a longer than the expected duration. The best approach to address this issue is through prevention using chlorhexidine gluconate in the form of wipes, baths or a gel to prevent the skin from being colonized by microorganisms. Since it has broad-spectrum properties, it is also used to conduct invasive surgical procedures and insert intravenous catheters. By implementing the proposed intervention, it is expected that the incidences, deaths, morbidities, costs, and complications will significantly reduce with increased patient and staff satisfaction and improved organizational financial performance (Boonyasiri et al., 2016).

Patient Care
CLABSIs negatively impact patient care. They result to prolonged admissions, complications, increase mortality and morbidity and healthcare-related costs which endanger the safety of patients and quality of care (Munoz-Price et al., 2012). When adequately addressed through prevention efforts, patient safety and quality care are guaranteed since complications, deaths, and morbidities are prevented with ultimately good health outcomes. Clinical Problem PICOT Statement Essay

Health Care Agency
High incidences of CLABSIs as evidenced by CLABSIs-associated deaths, morbidities and costs are reported in a regional-based critical care setting with a 300 bed-capacity. This agency serves both male and female adults and children by providing surgical and critical care to approximately 100,000 people. Although the agency is composed of different healthcare staff, nurses comprise the majority of the healthcare workforce. However, due to poor infection control measures, this agency has recorded high incidences of morbidities, deaths and medical-related costs in the ICU setting in the past 3 months. Besides, poor health outcomes has negatively impacted the agency’s reputation and financial performance.

Nursing Practice
Nurses working in ICU settings are expected to routinely use chlorhexidine wipes to reduce colonization of the skin with bacteria, to decontaminate hands and nursing environment surfaces. This also helps to reduce the likelihood of colonization with multi-drug resistance organisms such as MRSA and VRE and assures good health outcomes, patient safety and quality care (Marschall et al., 2014). High rates of CLABSIs should urgently be addressed as a quality health improvement issue. Clinical Problem PICOT Statement Essay

PICOT Statement

Among adult patients in the ICU with a central line (Population) does the use
of chlorhexidine wipes (Intervention) compared to traditional soap and water basin baths
(Comparison) reduce the rates of CLABSIs (Outcome) within 10 weeks (Time)?

References

Boonyasiri, A., Thaisiam, P., Permpikul, C., Judaeng, T., Suiwongsa, B., Apiradeewajeset, N., & Thamlikitkul, V. (2016). Effectiveness of chlorhexidine wipes for the prevention of multidrug-resistant bacterial colonization and hospital-acquired infections in intensive care unit patients: a randomized trial in Thailand. infection control & hospital epidemiology, 37(3), 245-253.

Frost, S. A., Alogso, M. C., Metcalfe, L., Lynch, J. M., Hunt, L., Sanghavi, R., & Hillman, K. M. (2016). Chlorhexidine bathing and healthcare-associated infections among adult intensive care patients: a systematic review and meta-analysis. Critical Care, 20(1), 379.

Munoz-Price, L. S., Dezfulian, C., Wyckoff, M., Lenchus, J. D., Rosalsky, M., Birnbach, D. J., & Arheart, K. L. (2012). Effectiveness of stepwise interventions targeted to decrease central catheter-associated bloodstream infections. Critical care medicine, 40(5), 1464-1469

Marschall, J., Mermel, L. A., Fakih, M., Hadaway, L., Kallen, A., O’Grady, N. P., & Yokoe, D. S. (2014). Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S89-S107. Clinical Problem PICOT Statement Essay